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Sec.13.04 RIGHTSOFSUBJECTSOFDATA <br /> Subdrvision 1. Type ojdata The rights of individual on whom the data is stored or to be slored shall be as set jorth in this section. <br /> Subd.2. Injormation required to be given individuaL An indivrdual asked to supply private or confidentral data concernrng him3i j <br /> shall be informed of.� (a)the purpose and intended use of the requested data within the collectrng state agenty,political subdivision,or statewide <br /> system;(b)whether he may refuse or rs legally required to supply the requested data;(c)any known consequence arisrng from hrs supplying or <br /> refusing to supply private or confidential data;and(d)the identity of other persons or entities authorrzed by state or federal law to receive the data. <br /> This requirement shall not apply when an individual is asked to supply investigative data,pursuant to section 13.82, subdivision S, to a!mv <br /> enforcement o�cer. <br /> The commissioner ofrevenue mav place the notice required under this subdivision in the individual income tuz or property tax refund <br /> instructions instead of on those forms. <br /> Subd.3. Access to data by individuaL Upon request to a responsible authoriry,an indivrdual shall be informed whether he is the subject <br /> of stored data an individuals, and whether it is classifted as public,private or conftdential. Upon his further request,an individual who is the <br /> subject ofstored private or public data on rndividuals shall be shown the data without any charge to him and, if he desires,shall be informed of <br /> the content and meaning of fhat data. After an individual has been shown the prrvate data and informed of its meaning, the data need not be <br /> disclosed to him for six months thereafter unless a dispute or actian pursuant to this section is pending or additronal data on the individual has <br /> been co!lected or created. The resporuible authorrry shall provide copres ojthe private or public data upon request by the individua!subject oj <br /> the data. The responsible authoriry may requrre the requesling person to pay the actual costs ojmakrng,cert�ing,and compiling the copies. <br /> The responsible authorrty shall comply immediately,ifpossible,wrth any request made pursuant to thrs subdivision,or within five days <br /> of the date of the request,excluding Saturdays,Sundays and lega!holidays,if immedrate compliance rs not possible. I,fhe cannot comply with the <br /> request within that time,he shall so inform the individual,and may have an additional frve days withrn whrch to comply with the request,excludrng <br /> Saturdays,Sundays and legal holidays. <br /> Subd.4. Procedure when data is not accur4te or complete.An individual may contest the accuracy or completeness ofpu6lic or private <br /> data concerning himselj. To exercise this right, an individua!shall notify in writing the responsrble authority describing the nature of the <br /> disagreement. The responsible authority shal!wrthrn 30 days either: (a)correct the datafound to be inaccurate or rncomplete and attempt to not� <br /> past recrpients of inaccurate or incomp/ete data,includrng recipients named by the rndivrdual;or(6)not�the individual that he believes the data <br /> to be correct. Data in dispute shall be disclosed only if the indivrdua!'s statement ojdisagreement is rncluded with the disclosed data. <br /> The determination of the responsrble authoriry may be appealed pursuant to the provisions of the administrative procedure act relating <br /> lo contested cases. <br /> DATA PRIVACYADVISORY <br /> InaccordancewrthM.S./3.04,Subd.2,"Rightsofsubjectsofdata",wewouldliketoinformyouthatyourrequestforapermrtorlrcense <br /> from the City of Orono or any of its departments may require you to furnish certain private or confidential rnformation. <br /> You are notifred that: <br /> /. The information you furnish wi!!be used[o defermine your qualifrcation for the permit or lrcense requested. <br /> 2. You may refuse to supply data, but refusal may require that the City deny the permit or license. <br /> 3. The rnformation may be shared with other local,state or federal agencies to the extent necessary to process the permit or <br /> lrcense. <br /> 4. Ijyour requested permit or license requires Council action to approve,some information may become pu6lic. <br /> 5. You have certain rights under M.S. 13.04(see jollowing page)to revrew private data on yourselJ. <br /> 6. Your ju(l name is required to process this applrcation or permit. <br /> PLEASE PRINT <br /> j c�t c ri� S J 1.,i,1 T?o <br /> First Middle Last <br /> �ti� �� U��� ti�-r p�-��-� <br /> Address <br /> �� �z o r—io �--t t�- '.���'�� ��l S 2 — `��l �J � Z�° l`� <br /> Crty S1ate Zip Phone <br /> I u�stand my rig s ated above. <br /> r �"Y�- .�-�l.� <br /> Signature t <br /> 10 <br />